An app a day keeps the doctor away

The founders of Lifesum, Remente and Natural Cycles on the future of digital health

16 Aug 2016, Fanny Siltberg

The advent of digital health solutions has enabled people to walk around with a personalised healthcare system in their pockets. Everything from Fitbits to dietary planning apps are changing the way we take care of ourselves and our bodies. At any given moment you are likely to be no more than an app away from finding a way to lose weight, practice mindfulness or get an overview of your diabetes. We met up with the founders of three of Sweden’s most prominent companies in the field, to discuss a day in the life of a digital health start-up.

How it all startedA couple of years ago, entrepreneur David Brudö was battling exhaustion. The stressful life of starting new companies was taking its toll and the traditional healthcare system seemed to answer none of his needs. The answer instead, came in the form of Remente - the company he went on to found in an effort to encourage mental wellbeing. Developed together with psychologists and personal coaches, the Remente app is supposed to work as a tool for personal growth and mental strength in order to prevent what happened to Brudö himself - exhaustion, depression and poor mental health. In July this year, the app boasted 100 000 users, a 400% increase since the start of the year. The demand, in other words, is big and Brudö explains that despite the stigma often surrounding questions of mental health, society is slowly waking up to the realisation that something needs to be done.

“Recently we have seen a big shift and increased interest in what we do from consumers, businesses and the healthcare sector, as the negligence for our mental wellbeing has become one of the costliest burdens in society”, he tells The LINK.

Brudö explains that three out of four people will directly or indirectly suffer from some sort of mental illness in their lifetime and in addition to that, the number one reason for sick leave in Sweden also stems from mental illness.

Around the same time that Brudö was struggling to find his bearings in life, Elina Berglund Scherwitzl was dealing with a personal challenge of her own. She and her husband was planning to extend their family and Berglund Scherwitzl was looking for a way to monitor her menstrual cycle while letting her body recover from 10 years of hormonal contraception.

“After doing some research on the topic, I discovered that the basal body temperature changes throughout the cycle and that it is therefore possible to detect ovulation in this way. I then started to write the first version of our current algorithm to use on myself.”

And so the solution, although unbeknownst to her at the time, became Natural Cycles, a company that today has an annual turnover of 1.8 million SEK and whose app is used by over 100 000 women. The app enables the user to determine fertility during their menstrual cycle, information that can then be used either to plan for a pregnancy, or the other way around, to plan for extra contraception in order to avoid one.

In January 2014, everyone who solemnly woved to start leading a healthier life on New Year’s Eve could fi nd a new offering in their app store. The previous month, Henrik Torstensson, Martin Wählby, Marcus Gners and Tove Westlund, had decided to launch Lifesum - a weight loss app promising to do more than just count calories. Rather than only controlling food intake, the app was meant to encourage a healthier lifestyle overall.

“We wanted to create something to support and encourage people to improve every aspect of their wellbeing”, co-founder Tove Westlund tells The LINK.

The concept is an appreciated one and since the launch some years back, Lifesum has been a worldwide success with 15 million users currently registered around the globe.

Lifesum wants to encourage their users to a healthier lifestyle

Natural Cycles and Remente grew out of personal needs and a conviction that the results could truly change people’s life.

“What we aim to create is a life management system, to help you lead a great life, which is not a small or trivial task. But that’s exactly why we are doing it, because somebody needs to”, Brudö says.

Berglund Scherwitzl touches on the same subject.

“What we provide is really a tool for women to gain insight about their bodies and fertility. With this knowledge they can then choose themselves what they want to do with it – do they want to get pregnant or do they not? Knowledge is the ultimate power.”

Westlund echoes the thoughts of Brudö and Berglund Scherwitzl and sees Lifesum as a part of a wider transformation in how digitalisation of health leads to personal control.

“There is a massive shift going on within healthcare, moving from reactive to proactive care. We are seeing consumer health technologies empowering people to take control over their lives”, she says.

Westlund also underlines another benefit of the digital development in healthcare.

“Apps are a fantastic way of educating people – by learning more about what exercise people can do and what nutrients they should consume more of, their lives can be changed for the better.”

The challengesEven though the market for health related apps is booming, being at the forefront of a new industry has its downsides.

At Remente, the taboo around mental health is a daily challenge, but the biggest obstacle of all has proven to be changing people’s habits for the better. Brudö explains that the inherent desire for a quick fix in all of us, often trumps the dedication to create a long term change in behaviour.

“We want to be less stressed but are we willing to work for it and challenge ourselves to make it happen? This is something everyone in this space are struggling with, we are putting a lot of effort into solving this at Remente. We can blame the shortsightedness of the human being, but this is the reality, and we have to find ways to motivate our users so that we don’t become another must do self-improvement app.”

The people at Natural Cycles on the other hand, face a different problem. As is often the case where digital progress creates disruptive markets, the legislative bodies have trouble adapting. According to Berglund Scherwitzl, understanding governmental regulations has been one of the most challenging elements in developing their product, and it also makes up for an uneven playing field.

“If the regulations are unclear there is a risk that some products don’t comply. In turn, that poses a potential risk for the consumer, as well as an unfair competitive advantage for companies that choose to ignore the regulations”, she says.

For Lifesum, the drawback of a booming market, is the boom itself.

“A challenge of developing Lifesum in general is the sheer size of the health market – there are constantly new apps and innovations hitting the space, so the challenge is staying ahead of the game”, Westlund says.

She explains how for Lifesum, that means continuously working on new updates for the users, and creating designs and interfaces that encourages continued use of the app.

The futureNatural Cycles is the only fertility application that is approved as a medical device in Sweden, and according to Swedish tech site Breakit. se, Remente is teaming up with the Swedish Association of Local Authorities and Regions for a new pilot project. In other words, both companies are slowly moving away from the tech start-up fi eld and towards the general health sector, making a telling example of how digital solutions are integrating more and more with traditional healthcare as we know it. Both Berglund Scherwitzl and Brudö believe that we have only seen the start of digital health solutions in society as a whole.

“I think digital health is really the future. It can cut a lot of costs for the government and at the same time give both better quality and much more personalised health care”, says Berglund Scherwitzl.

Brudö thinks that digital health solutions can substitute traditional health care in due time and that, as artificial intelligence becomes more advanced, machines will most likely be able to give better treatments and diagnosis than what man can do today.

“Digital health has the potential to make healthcare more preventive than reactive, which is its default state today, and also more available and affordable. I think we’re just seeing the beginning of a digital transformation in healthcare”, he explains.

Tove Westlund agrees, but sees digital solutions as a complement to traditional healthcare rather than a substitute.

“There is a clear distinction between healthcare and apps that help you improve your health as well as your general lifestyle. I would say that digital solutions can definitely enhance healthcare but not replace it”, she tells The LINK.

And it seems that neither three of the founders are far off in their predictions. The digitalisation of healthcare is evident in both Sweden and in the UK. Here, the NHS is developing the NHS Health App Library where patients are directed to NHS approved applications based on their medical needs. In Sweden, the first completely digital health centre, Kry, launched last year. At Kry, patients throughout Sweden can schedule a doctor’s appointment online and then carry out the whole consultation from home. All that is needed is a working internet connection and a webcam. The future, it seems, is already here.